In almost all respirators, leaks can occur, which are either system-related, as a result of a mask that has not been put on tightly enough, or patient-related, for example, in the form of a fistula. This leak generally depends on the positive pressure respiration and on the respiration method used. A distinction is to be made here between pressure-controlled and volume-controlled respiration.
In volume-controlled respiration, the inspiration takes place as predetermined by the stroke volume and by the time curve of the volume flow, and the respiratory tract pressure is dependent upon the volume flow and the stroke volume. The level of the respiratory tract pressure essentially depends on the lungs of the patient and also on the breathing efforts of the patient. In the volume-controlled respiration, it is necessary to monitor the upper respiratory tract pressure in order to prevent a lung of the patient from becoming damaged due to too high pressures. The rigid predetermination of the time curve of the volume flow has a problematic effect, if the patient develops his/her own activity during the breathing and thus wants to determine the volume flow himself/herself.
Pressure-controlled respiration takes place as predetermined by the time curve of the respiratory tract pressure. In this case, so much breathing gas is supplied until a predetermined respiratory tract pressure is reached. In pressure-controlled respiration, the volume flow and the stroke volume are monitored. If the breathing gas for respirating a patient is provided via a fan as a pressure source, then the respiration usually takes place as predetermined by the pressure curve, since the respiratory tract pressure, but not the volume flow can be adjusted via a regulation of the speed of the fan in a relatively simple way. The possibility of also predetermining the stroke volume here is desirable.
To compensate for a leak in pressure-controlled respiration, a so-called compensating gas flow is added, so that the respiratory tract pressure can be maintained at the preselected pressure level.
In the volume-controlled respiration, the added compensating gas flow should be included in the calculation of the stroke volume. The compensation for a leak by means of adding a compensating gas flow also interferes with the setting of the trigger thresholds, with which an inspiration stroke is triggered.
Since the system leak has different effects on the system functionalities of the respirator, accurate knowledge thereof is important in order to be able to make a suitable compensation. In the prior-art respirators, usually a linear or square root dependence of the leak is based on the respiration pressure.
A square root dependence between a leak and the respiration pressure for a respirator with a fan emerges, for example, from U.S. Pat. No. 6,659,101 B2.
The drawback in this case is that a characteristic curve limited to the square root function can only approximate the different leak forms approximately.